<div class="box">
    <div class="col-lg-12 text-center">
    
        <h1 class="brand-name">Enregistrement</h1>
        <hr class="hrLineTitle">
    </div>
    <?php echo form_open('book/addNewCustomerShippig','class="addNewCustomerShippig form-horizontal"'); ?>
        <div class="col-lg-8 col-lg-offset-2">
            <div class="form-group">
                <label class="col-lg-3">Mon nom</label>
                <div class="col-md-9">
                	<input type="text" name="txtfname" class="form-control no_radus left field" placeholder="Mon nom"/><br/>
                    
                </div>
            </div>
            <div class="form-group">
                <label class="col-lg-3">Mon adresse mail</label>
                <div class="col-md-9">
                    <input type="text" name="email" value="<?php echo $this->session->userdata('email'); ?>" class="form-control no_radus left field"  placeholder="Entrez votre adresse mail" />
                </div>
            </div> 
             <div class="form-group">
                <label class="col-lg-3">Entrer un nouveau code</label>
                <div class="col-md-9">
                    <input type="password" name="password" value="" class="form-control no_radus left field" id="password"  placeholder="Code" />
                </div>
            </div> 
            <div class="form-group">
                <label class="col-lg-3">Confirmer le code</label>
                <div class="col-md-9">
                    <input type="password" name="passwordConfirm" value="" class="form-control no_radus left field"  placeholder="Confirmer le code" />
                </div>
            </div> 
             <div class="form-group">
                <div class="col-lg-3">

                </div>
                <div class="col-md-9">
                   
                    <input type="submit" class="btn btn-primary no_radus"  value="Enregistrer" />
                </div>
            </div> 
        </div> 
    </form>
</div>